What do to with immature eggs in IVF?

Immature eggs in IVF normally don’t make healthy embryos on fertilization but if they are allowed to mature in the laboratory for an extra day, they may turn into healthy, mature eggs that are capable of fertilizing well.

This process of delaying the fertilization of immature eggs collected from the ovaries is called delayed IVF or late fertilization pregnancy.

The fertilization potential of mature vs immature eggs in IVF is significant—while some clinics will allow them to go waste, there are a few clinics that are able to perform in-vitro maturation (IVM) to allow immature eggs to mature under controlled conditions in a laboratory so that they can become viable for use in IVF treatment.

Here's answering your two other points:

What are the causes of immature eggs in IVF?

1. Lower ovarian reserve: In a study of 195 IVF cycles (2), researchers found that the percentage of immature eggs increased with female age. Women over 40 years of age had the highest number of immature eggs.
2. Improper ovarian stimulation protocol: During IVF, not all follicles respond optimally to ovarian stimulation and the maturation of eggs may also be impacted by your body’s response to the drugs. An experienced doctor should be able to adjust the medications and their dosages to optimize follicular development for you.
3. Premature ovulation: If the HCG trigger injection is administered too soon in the cycle, it could result in premature ovulation before the eggs have reached maturity.
4. Underlying ovarian conditions: Conditions such as polycystic ovarian syndrome (PCOS) or premature ovarian insufficiency (POI) cause higher chances of retrieving immature eggs in IVF.
5. Poor ovarian function: Advanced age and lifestyle factors such as stress, smoking, excessive alcohol, poor nutrition, etc. can negatively impact ovarian function and result in the retrieval of immature eggs.
6. Ovarian damage due to prior surgery: Any damage to the ovaries may cause problems in the development and maturation of eggs, and as result the eggs retrieved may be immature.

What is the IVF protocol for immature eggs?

In the absence of mature eggs in the COC, the IVF cycle may be canceled, but if your clinic is equipped for in-vitro maturation of eggs, you could simply adapt to delayed IVF.

The original process of oocyte in vitro maturation (IVM) or delayed IVF has been available since the 1990s, but not all clinics offer the treatment as it is technically quite challenging.